Hospital Preparedness Program (HPP) & Public Health Emergency Preparedness (PHEP) Grant Alignment 10/20121 Kansas Regional Preparedness Training 2012

Hospital Preparedness Program (HPP) & Public Health Emergency Preparedness (PHEP)

Grant Alignment 10/2012 1Kansas Regional Preparedness Training

2012

Grant Alignment Requirement

• White House directed– Better alignment of emergency preparedness programs

• HPP and PHEP awardee requested– Reduce duplicative/conflicting activities and redundancies DHHS preparedness awards nearing $1 billion

annually• Funding sustainability requires demonstration of

how funding has:– Increased operational efficiencies– Improved preparedness integration across the federal government,

with partners and with the public– Improved national public health and medical preparedness

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HPP-PHEP Cooperative Agreement

• Capabilities-based approach• Building upon the strong preparedness

foundation already in place• Benefits

– More coordinated and integrated public health and healthcare service delivery system planning and response

– Improved ability to leverage funding for applicable activities and infrastructure

– Reduced burden regarding duplicative and conflicting activities and reporting


• Aims to broaden the scope of the healthcare service delivery systems preparedness from individual facilities to diverse regional healthcare coalitions (HCC)

• Allows program to identify gaps in preparedness, determine specific priorities, and develop plans for building and sustaining specific capabilities

Shift from Building to Strengthening


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Healthcare Coalition (HCC)

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Health and Human Services

Definition of healthcare coalition (HCC):

A collaborative network of healthcare organizations and their respective public and private sector response partners that serve as

a multiagency coordinating group to assist with preparedness, response, recovery, and

mitigation activities related to healthcare organization disaster operations.


7Kansas Regional Preparedness Training 2012

One individual agency/organization Two individual agencies/organizations Hospital-only regional group Public health-only regional group A deployable response team Made up primarily of individuals, but of organizations

• A Multi-agency coordination group that includes multiple healthcare organization members (HCOs) within the response community• A collective team that assists Emergency Management and Emergency Support Function (ESF) #8 partners• A collaborative effort to plan, organize, equip, train, exercise, evaluate and outline corrective actions

IS NOTIS NOTISIS

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• Conduct non-preparedness or non-response related activities or business• “Command” the actions of Coalition members or any other response entities it might interact with during an emergency• Use only one county-level Hazard Vulnerability Assessment (HVA) for substitution of the entire regional HVA

• Focus on the cycle of preparedness, response, recovery, and mitigation activities • Promote situational awareness for HCOs• Conduct regional healthcare coalition meetings• Engage partners in Hazard Vulnerability Assessment (HVA) discussions

DOES NOTDOES NOTDOESDOES

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• Have to own the electronic systems being shared or utilized within the region• Have to have the resources locally, but have access to resources within the region

• Have the ability to share Essential Elements of Information (EEIs) data electronically across the HCC (e.g., bed status)• Utilize subject matter experts from across the region for information sharing

DOES NOTDOES NOTDOESDOES

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Primary Function of HCC

Sub-state regional healthcare system emergency preparedness activities involving the healthcare

member organizations (HCOs). This includes planning, organizing, equipping, training, exercises and

evaluation.

Purpose of HCC

Healthcare system-wide approach for preparing for, responding to, and recovering from incidents that have

a public health and medical impact in the short-and long-term.

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Response of HCC

HCCs should represent healthcare organizations by providing multi-agency coordination advice on decisions made by incident management regarding information &

resource coordination

Advice through:

• A multi-agency coordination group to assist incident management (area command or unified command)

OR

• Through coordinated plans to guide decisions regarding healthcare organization support

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Healthcare Coalition Member Organizations (HCO)




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• Regional-based preparedness programs already in place

• Common purpose:– To serve as a collaborative network of

healthcare organizations to assist with preparedness, response, recovery, and mitigation activities related to healthcare organization disaster operations.


Don’t Recreate the wheel! Use existing networks.

Kansas Healthcare Coalitions


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• Most states are choosing to utilize their current regional structure for healthcare coalitions

• Some are using State as one coalition• Few states are using city or county

based communities

Non-Kansas Healthcare Coalitions



Five Year Grant Period

Working in close collaboration with internal and external subject matter experts (SMEs), ASPR and CDC developed a set of new performance measures for 2012-2013 that enable ASPR and its HPP awardees to:

• Enhance situational awareness • Provide technical assistance• Support program improvement and inform policy• Increase transparency• Promote sound stewardship of Federal tax dollars by using the

data to assess impact of public funding and ensure that the American taxpayer sees a return on his or her investment.

– The development of program measures and continuous quality improvement enables Healthcare Systems Evaluation Branch (HSEB) within ASPR to critically evaluate the ability of the HPP program to perform its intended goals.

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The Assistant Secretary for Preparedness and Response (ASPR) has always supported region-based approaches for preparedness planning. This has been a part of the preparedness program for many years.

You can learn more from the ASPR 2009 report, From Hospitals to Healthcare Coalitions: Transforming Health Preparedness & Response in Our Communities. In this report, ASPR highlighted the seven Kansas regional hospital groups as a best practice for collaborative efforts resulting in shared resources and stronger relationships. This is the structure that will continue to be used moving forward.


http://www.phe.gov/Preparedness/planning/hpp/Documents/hpp-healthcare-coalitions.pdf

http://www.phe.gov/Preparedness/planning/hpp/Documents/hpp-healthcare-coalitions.pdf


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Challenges & SolutionsChallenge Example #1: Preparedness funding realities

Possible Solutions: • Capitalize on policy initiatives and resources

• Military. Force Multiplier--A capability that, when added to and employed by a combat force, significantly increases the combat potential of that force and thus enhances the probability of successful mission accomplishment.

• Racing. Drafting or slipstreaming is a technique where two vehicles or other moving objects are caused to align in a close group reducing the overall effect of drag

• Collaboration Effect


National Healthcare System

Gap

Coalitions

Regional Preparedness

100% Prepared

Collaboration Effect


National Healthcare System

100% Prepared

Gap

Coalitions

Regional Preparedness

Collaboration Effect


National Healthcare

System

100% Prepared

Achieving Success


Challenges & SolutionsChallenge Example #2: Coalition integration into disaster response

Possible Solution:


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Challenges & SolutionsChallenge Example #3: “surge” capacity“Surge” capacity is shrinking

Possible Solution: Coalition immediate bed availability

Immediate bed availability (IBA) is built into the existing systemUses regional capacityExpanding local capabilitiesBuilds on current regional structuresBuilds on regional collaboration

IBA principlesConstant acuity monitoring across the coalition Patient awareness and continuous discharge planning20% acute care offload (IBA)


Immediate Bed Availability


Stroke/MIs

High Acuity Psychiatric patients

ICU Patients

Acute Surgical Patients

Imminent OB deliveryLesser Acuity

Awaiting discharge

Behavioral Health Issues

Social Issues

Post Operative Patients

Elective Procedures Cancelled

Home

Community Health Centers

Long Term Care

Acute

Hospitals Coalition Partners

20%

EVEN

TCoalitions & Immediate Bed Availability


• Coordinated near-simultaneous attacks targeting commuter trains

• 191 dead

• More than 2,600 injured

Challenges & SolutionsCase Study: Madrid 3/11/2004






• 1000 acute care beds/coalition• 20% IBA• Results in 200 beds immediately avail/coalition• 100 coalitions in the United States• Across the U.S., 20,000 beds available—

immediately• Madrid = 2,000 patients

- Require 10 coalitions engaged

Challenges & SolutionsFunctional IBA? Discussions across HCCs


ResourcesBest Practices


Coalition Strengthening Documents


10/2012

Kansas defined Tier 1-4 Coordination
